Dental coupling



J. B. BOUTET DENTAL COUPLI NG Dec. 12, 1933.

Filed April 25, 1932 Job 71133011162 IN VENTOR A TTORNE Y5 Patented Dec.12, 1933 UNITED STATES PATENT OFFICE 4 Claims.

The present invention relates to a removable denture or removable bridgeand has for an obiect the provision of a device of this kind which isadapted to be suspended between and an- 5 chored to the natural teeth onopposite sides of the void or space occasioned by the loss of one ormore intervening teeth, in such a way as to be readily removed andreplaced by the fingers of the wearer but without danger of becomingseparated or disengaged during the act of mastication.

Another object is to provide a means and method of removably mounting anartificial bridge consisting of one or more teeth at practically anylocation in the mouth in such a way as to be absolutely secure for theintended pur pose and without having any of the mounting and supportingmeans visible from the outer or buccal side.

Another object is to provide a method of making and. mounting artificialdentures so that a minimum of work is performed in the mouth of thepatient, whereby much time is saved for the patient, and a great deal oftime is saved and tedious effort avoided on the part of the dentalprosthetist, and to furthermore provide a coupling means which may bestandard for all types of bridge work regardless of the particular toothor teeth to which they are intended to be attached.

Another object is to provide an artificial bridge wherein the supportingmeans are seated in and are disposed centrally of the occlusal surfacesfor taking the biting strain and wherein the attaching means orcouplings for said bridge are disposed in the lingual inter-proximalspaces between the bridge or pontic and inlays which are mounted in theexisting natural teeth adjacent thereto; the combination thus eifectedgiving all of the desired strength to resist biting stress and at thesame time avoiding displacement but permitting a movement simulating therocking of a natural tooth in its socket under the same conditions, andin this way providing an accommodation of the artificial bridge to themovement or" the existing natural teeth and avoiding the rapid breakingdown of the natural teeth which has heretofore been an attendantcircumstance with the use or" removable bridges.

Another object is to provide a coupling means for the removableattachment of dental bridges or pontics which is capable of beingstandard in construction and which is furthermore adapted for reversalof the coupling members at the time of constructing the particularbridge or pontic.

Another and further object of the invention is to provide couplingmembers of the class referred to with a means whereby the alignment ofthe couplings in all planes'is accomplished simply, accurately, andquickly.

These and other objects are attained by the means described herein anddisclosed in the accompanying drawing, in which:

Fig. 1 is a fragmental elevational view of the natural teeth adjacent aspace occasioned by the loss of a tooth and showing in positionsubstantially all of the dental or inlay work which must be performedwithin the patients mouth.

Fig. 2 is a view taken on line 2--2 of Fig. 1 showing the inlays in thenatural teeth and the sockets in the inlays for receiving the stressbearing portions of the removable replacement or pontic.

Fig. 3 is a view showing the natural teeth with the inlays in positionand a mass ofimpression material in place.

Fig. 4 is a cross sectional view of a model made from the impressionshown in Fig. 3 and having the inlays set therein.

Fig. 5 is a cross sectional view of an impres- 180 sion made from themodel shown in Fig. 4.

Fig. 6 is an enlarged cross sectional view showing a fragment of themodel made from the impression in Fig. 5 and having the wax form inposition preparatory to casting the basket or supporting means for theartificial porcelain tooth.

Fig. 7 is a view taken on the lingual or tongue side of the naturalmouth with the completed replacement in position and showing thecouplings of the invention.

Fig. 8 is an enlarged top plan view showing the method of mounting thecouplings and aligning them with the teeth prior to soldering thecoupling members to the basket member and the inlays respectively.

Fig. 9 is a view taken on line 99 of Fig. '7.

Fig. 10 is a perspective view of a pair of coupling members in separatedcondition.

Fig. 11 is an enlarged fragmental cross sectional view showing thecoupling members in engaged relation.

Fig. 12 is a view similar to Fig. 11 showing a modified form of thecoupling.

Heretofore there were two disadvantages in the making and in the use ofremovable dental bridge work. In making them much tedious work in thepatients mouth and in the laboratory was required to align thereplacement tooth or denture; and the supporting teeth usually requiredexcessive cutting away so that painful nerve irritation of the tooth wasinvolved in order to seat the inlays in the supporting teeth. Otherdifficulties and disadvantages were that these heretofore used removablebridges were not well adapted functionally for use in the upper or lowerdental arch.

The present device is usable in the front of either arch because it isfree of encircling hooks or bands.

The method and means of the present invention provide for thereplacement of missing teeth at any place in either dental arch withcomplete invisibility, with security against displacement during use andare nevertheless readily removable by means of the fingers of thewearer. Furthermore the replacements thus effected are comfortable tothe wearer and have none of the derogatory effects on the supportingteeth which are common to other types of removable dental bridges.

The method and means of the present invention will be describedconcurrently with reference to the drawing as the description proceeds.As shown in Fig. l the pair of support teeth 12 and 13 be any two teethin the upper or lower dental arch having a void 14 between themoccasioned by the removal or loss of a tooth. The support teeth 12 and13 are ground to form a shallow shoulder for a distance well over theocclusal surfaces and, to a greater depth along their adjacent faces andinlays 15 and 16 are made and temporarily inserted in the naturalsupport teeth 12 and 13. It is to be noted that these inlays 15 and 16are so made as to allow the lingual aspect of each inlay to cover aboutone-third of its proximo-distal-dimension and then continues about theproximal surfaces into the occlusal surfaces to insure proper dove-tailanchorage. The proximo-lingual surfaces 1'7 and 18 of the inlays 15 and16 do not follow or fill out completely the belly or contour of thenatural tooth surface but preferably slope away to provide a more acuteangle at the proximc-lingual angle of the tooth. This can be bestappreciated in Fig. 8 wherein the coupling means of the in vention areshown in position preparatory to permanently securing them to the inlaysand the tooth. A generally rectangular concavity 19 and a similarconcavity 20 are formed in the inlays 1'7 and 18 mid-way between thetongue side and cheek side of the teeth and are open on the occlusalsurfaces and at the proximal sides.

These inlays l5 and 16 are temporarily inserted in their proper placesin the support teeth 12 and 13; and while in this position, a bite ofwax is taken in order to enable the dentist to later properly carve theocclusal surfaces of the finished replacement.

With the inlays temporarily in position, as aforesaid, an impression istaken of a quick-setting plastic substance which does not expand norcontract upon setting but which may disintegrate in boiling water. Thisstep is shown in Fig. 3 with the quick-setting plastic impressionmaterial 21 in place. Into this impression 21 the inlays are placed intheir proper positions after which a model of refractory material whichis not subject to thermal changes is made from the impression 21. Thismodel 22 with the inlays l5 and 16 therein is now an accurate replica ofthe corresponding part of the patients mouth and constitutes the modelupon which all the work of making the bridge will be done. Forconvenience, this may be referred. to as model No. 1.

The model, it will be appreciated, is of refractory material. This modelis now saturated with water and the external surface thereof is coveredwith a light oil to permit a second impression to be made of the model.This second impression is of a substance well known to the dental artand is of such nature that it is plastic and soft when hot but, whencooled, becomes relatively hard and elastic so that it will resume theshape to which it was molded while hot. This may be referred to as anelastic i1 .pression and is used to make a second model, No. 2, of thesame material as the first model or model No. l. The second model is tobe used for making the suspensory member or basket for the bridge. Ihismodel is cut away slightly at the sides corresponding to the inlays sothat a slightly oversize suspending member may be made with the resultthat the dentist may ultimately have material to grind away slightly toinsure contact between the replacement and the supporting teeth which isidentical with the contact which obtained when all of the natural teethwere present. The impression of the elastic material is shown at 23 (seeFig. 5). terial made therefrom is shown in enlarged cross section at 24(see Fig. 6). Fig. 6 is a cross section of the model No. 2 into whichthe cast gold for the suspending member or basket is poured.

In making the removable tooth or bridge, inlay wax is placed in thespace in model No. 2 of the refractory mater al 24 and the porcelain orother replacement tooth or teeth fitted into position and waxed inplace. Two lugs of wax conforming to the concavities l9 and 2D in theinlays are made at the distal ends of this wax pattern. The wax patternis then adapted to suit the artificial tooth. The disal ends of the waxpattern are shaped so as to allow a large V-shaped space to existbetween the said ends and the proximal surfaces of the abutment teeth,diverging toward the lingual or tongue side of the pontic and abutmentteeth with the vertex of the V extending toward the cheek side or buccaland thus providing a wide inter-proximal space on the lingualof theabutting teeth and the distal of the replacement or pontic.

The porcelain tooth or teeth are then removed from the wax pattern andthe gold casting is The impression in refractory mamade by the usualmethod, namely the building up of thin wax rods or sprews 25 filling upthe space between and above with refractory clay 26 and melting andcarbonizing the wax by high heat whereby a space is caused wherein theencased wax pattern formerly existed in the mold. after which the goldis forced. into the hollow mold thus effected.

A central peg or rod is cast integrally with the resulting gold casting28, said rod or pin 29 corresponding with the central wax portion 27shown in Fig. 6. This cast gold member then receives the usual grindingand polishing and is fitted in its proper position between the abutmentteeth 120 and of model No. l which correspond with the natural abutmentteeth 12 and 13. The waxconstitute occlusal rests which permit thepontic or basket member to suspend itself from the abutment teeth andthey are countersunk into the inlays to hold them against lateralmobility and play. This basket member is temporarily fastened to modelNo. 1 with wax.

The device, as shown in Fig. 8, should now be considered. To provide forthe removable attachment of the basket with the inlay of the abutmentteeth, a pin and socket coupling member is provided. One form of thismember is shown with the elements separated in Fig. 10. It consists of afemale member indicated generally as 32 and a male member indicatedgenerally as 33. The female member has at its one end the longitudinallyslitted tube 34, the opposite ends of which have a tapered counterbore35. The main body 36 of female member 32 extends radially from the tubeportion 34 for a distance and is then turned upon itself so that thealigning lug 37 extends at right angles to the main body. Acorresponding main body on the male member likewise has an aligning lug3'7 disposed in the same relation. At the coupling end of this body is apin 38 having a knobular head 39. 'The split tube 34 of the femalemember is somewhat resilient so that when the end 39 of the male memberis forced against the countersunk bore, it will spread the tube and passinto it whereupon the counterbored opposite ends 35 of the tube willseat on the correspondingly tapered top and bottom portions 40 of themale coupling and the two members will center themselves longitudinallydue to the contractile tendency of the split tubular female couplingmember. These members are amply secure in their normal couple connectionbut may be readily separated by digital force. It is to be understoodthat these coupling members may be varied to some extent in constructionso long as one of the members has suitably resilient characteristics.Also, as shown in Fig. 12, the female body 36 may have a truncatedconical slotted tube member 41 and the male body 36 a correspondingtruncated conical pin 42, these members being internally and externallytaper shouldered at their ends, as shown as a matter of preference. Thebody members are of course provided with the aligning lugs 37 similar tothose shown in Fig. 19. This taper pin and socket form of coupling ispreferable in that the socket and pin are not only longitudinallyself-centering but a pair of said couplings mounted, for example, asshown in Fig. 8, will mutually cooperate even though a degree of errorexists in the work of attaching the parts of the bridge and inlays.Furthermore, it will be possible for the skilled worker to align membersof this type accurately by sighting along the alignment lugs, since, incoupling the slotted tube does not have to spread its entire lengthduring the passage of the knobular male head. The coupling members areapplied one pair in each of the interproximal spaces on the lingual sideof the dental arch. As aforementioned, it is clearly shown in Fig. 8. Inthe embodiment shown the body 36 of the male coupling member would besecured to the inlays and relatively close to the bottom thereof. Inthis case the female coupling member would be secured to the basket orpontic member and relatively closer to the occlusal surface of thereplacement tooth. These couplings, however, are capable of inversionrelative to the method of attachment just named. In Figs. '7 and 8, bothupstanding and depending male members are shown in order that thedrawing may be fully illustrative. Common practice would normallyindicate to have either both male members or both female membersattached to the inlays and the remaining members to the pontic or viceversa. It is a highly desirable feature to have the coupling memberscapable of this inversion since the shape and size of various teeth andtheir locations may make such installations desirable. I

The mode of aligning and arranging the basket or pontic member 28 sothat the replacement porcelain or other replacement 43 may be properlypositioned without difficulty is as follows. Referring to Fig. 8, itwill be seen that the gold inlays l5 and 16 are in position and that thebasket or suspending member 28 is in position between them with thesupport lugs 30 and 31 seating in the inlays or cavities l9 and 20,respectively. The female member 32 would then have the body portionthereof placed against one of the arms 44 of the basket member andlightly held in place with a bit of wax. The male member 33 wouldlikewise then be lightly held in place with a bit of wax on the face ofinlay 15. In the same manner a second coupling member would be held inplace on the basket and the inlay 16. In order that these couplings maybe properly aligned, either the uppermost wings or ends 37 of the twocouplings or, if desired, the lowermost of said wings are stuck tightlybut temporarily with wax onto a straight edge such as a small steel rule45 (with the couplings in assembled condition) thus automaticallyaligning the pair of couplings in all planes. When the parts are in theposition shown in Fig. 8 (i. e. when the body members are in contactwith the basket and respective inlays, and all lightly but temporarilyheld in place with wax), a suitable investment material is painted overthe pin and tube connection to exclude the flux of solder thereinto; andthe body portions 36 are then soldered to the respective parts withsuitable gold solder. The inlays, basket member, and supporting lug, allhaving been held in exact aligned position by investment material andthe straight edge removed, the soldering is quickly and positively done,after which the wings 37 are cut off and the basket member with itscoupling members attached is removed and the inlays are also removedfrom the model. All parts are then ground and polished and the porcelainor other replacement tooth is cemented into the gold casting includingthe center rod 29, whereupon the parts are polished and ground to affordproper contact between the inlays and replacement. The inlays are thenpermanently mounted in the natural teeth whereupon the replacement orbridge is ready to be inserted for use by the wearer. In inserting thebridge or replacement, the wearer merely positions it in the spacebetween the abutment teeth andpresses it into its functional positionwhereupon the resilient female or male member (as the case may be)yields sufficiently to allow the coupling members to engage. Thereplacement now has all the attributes of a natural tooth insofar aslikelihood of accidental separation during mastication and as tocomfort. The coupling portions, it will be noted, especially in Fig. 7,are set well into the interproxirnal spaces on the lingual side of thearch so that there is no strange or uncomfortable feeling to the tongue.After eating and such other times as it is found desirable to cleansethe replacement, the wearer of the teeth need merely take a firm grip onthe replacement and pull it free of the coupling members which are r Itshould be teeth are exposed while all of the coupling members orportions are sealed on the inside of the arch so that only closeinspection of the open mouth will reveal them.

As to the coupling means, it is especially to be noted that the aligningwings 37 extend initially well beyond the lingual alignment of the teethfor the purpose of facilitating the positioning of the parts for thepurpose of waxing them into position preparatory to the solderingoperation.

As alternative laboratory technique, model No. 1 may be a metal die andthe wax pattern may be fashioned on this model, then removed and a goldor other casting made therefrom. Then the casting or suspending membermay be mounted in position on the metal die and a model made therefrom.The inlays and suspending casting would then be mounted on therefractory model and the soldering operation completed as in thepreviously described method.

What is claimed is:

1. In a dental coupling the combination of a flat strip member, a headedpin extending lateral- 1y of one end of said strip member, a portion ofthe opposite end of said strip being twisted through ninety degrees onthe longitudinal axis of said strip, a second strip member twisted atone end like the first member, and a hollow socket on the opposite endof the second member and seating between the first member and the headof the pin on said first member.

2. In a device for detachably coupling dental bridge Work to abutmentteeth, the combination of a pair of flat body members for fixation to abridge and a 'tooth respectively, a headed pin extending vertically ofone of said members, and a slotted resilient socket on the other of saidmembers for detachably receiving said pin, said pin and said socketbeing complementarily tapered at opposite ends whereby the pin andsocket automatically center themselves longitudinally the one in theother.

3. As a new article of manufacture a separable anchoring couplingcomprising a pair of body members for attachment to a removable bridgeanda supporting tooth respectively, a tapered pin extending laterally ofan end of one body member, a tapered socket member on the other bodymember adapted to slidably receive the pin to effect a hinged couplingof the body members, and extended transverse alignment lugs on both saidbody members for paralleling a plurality of said anchorage couplings.

e. In a dental coupling the combination of a pair of separable bodymembers each provided at oneend with an extended transverse aligninglug, one body having a tapered pin at the free end perpendicular to itsaligning lug, the other body having a longitudinally slotted truncatedconical sleeve perpendicular to its aligning lug, the sleeve having atapered counter bore at each end, and tapered base and head portions onthe pin cooperating with the counter-bored portions of the sleeveserving to preclude accidental longitudinal relative shifting of thesleeve and pin.

JOHN B. BOUTET.

